HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: cp Y. Permit Number.
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Building Permit Applic tion FEB - 8 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie
2300 Virginia Avenue, Fort Pierce FL 34982 u n t,/r FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residentia
PERMITTYPE:
PROPOSaINPI .�
Address: d e"Aeg5 u0oe
Property Tax ID#: 3 V t9V.- /V07- 0® 0 �� ®� �� Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED'DESCIPTIQN { FuWf}RK ,y$
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Additional work to be performed under this permit-check all that apply:
—Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
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Cost of Construction:$ Utilities: _Sewer _Septic Building Height:
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Name , S Name:G. t r.4A,,7
Address: f'� - .'•� LN Company: ' d efi Iso• if C'iQA114,
City: f 1. orcP State: C. Address: 9ara /L1.1v �t'ar-r'
Zip Code: S49ga Fax: city: rk: Arrkeg State:-k !
Phone No. Zip Code: Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License L f$-6-7 1-1-4
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRCfCT10N IN,
LAW INFORMATION
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�- DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable.
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature of Own er/esee/Contractor as Ager Signature of Contractor/License Holder
��?l�•*NPT: ais.:�.,h0t
STATE OF FLORI r _ STATE OF FLORIDA
COUNTY OF .s��* COUNTY OF1.
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The fo oing instrum was acknowledged bef ego o The f . oing instrume t was acknowledged before .�<c
this 6 da of 20-b y
y y z� this day of 20� b z mS m
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Name of person makings tement. Name of person making statement. rn
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Personally Known OR Produced Identifica Personally Known OR Produced Identificati �$j
Type of Identification Type of Identification
Produced Produced
(Signature oMotary Public-State of Florida ff (Signature of tary Public-State of Florida )
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
lev. 9/26/18